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The comparison of general movements assessment and neurological examination during early infancy
Büşra Kepenek-Varol1, Mine Çalışkan2, Zeynep İnce3
1Department of Physiotherapy and Rehabilitation, Bezmialem Vakif University Faculty of Health Sciences, Istanbul, Turkey.
Insights
General movements (GMs) assessment effectively identifies neurologic disorders in high-risk infants. This method shows strong agreement with neurologic exams and cranial ultrasonography, aiding early diagnosis.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement analysis
Background:
- High-risk infants, including those with low birth weight and prematurity, require accurate methods for early neurologic assessment.
- General movements (GMs) offer a non-invasive approach to evaluating early motor repertoire.
- Comparing GMs with established neurodevelopmental assessments is crucial for validating its utility.
Purpose of the Study:
- To evaluate general movements (GMs) in high-risk, low-birth-weight, and preterm infants.
- To compare GMs assessment findings with neurologic examinations and other neurodevelopmental scales.
- To determine the diagnostic value of GMs in identifying potential neurologic disorders.
Main Methods:
- Prospective, single-blinded study involving 22 high-risk infants.
- General movements (GMs) were recorded and analyzed.
- Neurologic examinations, Gross Motor Function Measurement (GMFM), and Bayley-III Scale were performed at 12 months corrected age.
Main Results:
- Complete agreement (kappa=1) was observed between GMs and neurologic examination findings.
- Significant agreement (kappa=0.76) was found between GMs and cranial ultrasonography.
- Infants with consistently abnormal GMs were classified as "abnormal," while those with normal or transiently abnormal GMs were classified as "normal."
- Statistically significant differences were noted between groups in GMFM "standing" and Bayley-III "cognitive" parameters.
Conclusions:
- General movements (GMs) assessment is a reliable tool for detecting neurologic disorders in high-risk infant populations.
- GMs serve as a valuable adjunct to traditional diagnostic techniques like neurologic examinations and cranial ultrasonography.
- Early identification of motor abnormalities through GMs can guide further neurodevelopmental evaluations.
Abstract:
This prospective single-blinded study was performed to evaluate general movements (GMs) in group of high-risk, low-birth-weight and preterm infants and to compare results with neurologic examination. All infants' neurologic examinations, Gross Motor Function Measurement (GMFM) and Bayley-III Scale were performed at the corrected age of 12 months. A total of 22 infants were included. Eight infants (group-1) (mean: 31.6±3.29 weeks, range: 25-36 weeks) had normal GMs in all recordings and were ultimately evaluated as "normal"; 12 (group-2) (mean: 31.6±3.29 weeks, range:2 5-35 weeks) had abnormal GMs during writhing movements period but had normal GMs in subsequent recordings and were evaluated as "normal"; and 2 infants (group-3) (mean:29.5±7.78 weeks, range:24-35 weeks) with consistent abnormal GMs who were evaluated as "abnormal." Complete agreement (kappa=1) was found between GMs and neurologic examination and significant agreement between GMs and cranial ultrasonography (kappa=0.76). When results of GMFM and Bayley-III were compared; statistically significant differences were found between group-1 and group-2 in "standing" parameter of GMFM (p < 0.05) and "cognitive" parameter of Bayley-III (p < 0.05). GMs assessment can help determine neurologic disorders in high-risk infant populations as an adjunct to other diagnostic techniques.
